Journal of midwifery & women's health最新文献

{"title":"Strengthening the Midwifery Workforce Through State Investment in Midwifery Education: The New Jersey Midwifery Education Project.","authors":"Julie Blumenfeld, Amy Alspaugh, Elizabeth Auricchio, Laura Lindberg","doi":"10.1111/jmwh.70174","DOIUrl":"https://doi.org/10.1111/jmwh.70174","url":null,"abstract":"<p><p>State-level investment in midwifery education strengthens the workforce by addressing long-standing structural barriers in training and clinical education. We describe the development, implementation, and early outcomes of the New Jersey Midwifery Education Project (NJ-MEP), a state-funded initiative designed to sustain, expand, and diversify the midwifery workforce through targeted improvements in educational and training infrastructure. The NJ-MEP's successes illustrate how policy engagement, advocacy, and sustained public funding are effective mechanisms to support midwifery workforce development and diversification. Core components of the NJ-MEP include (1) financial and educational support for clinical preceptors; (2) financial investment in midwifery students through scholarships, mentoring, and academic coaching; (3) the creation of a dedicated midwifery simulation center; and (4) the development of a coordinated research agenda focused on clinical education quality and workforce development. Preceptor initiatives combine financial support with educational programming, including in-person workshops and an online learning platform. Student scholarship funding, combined with mentoring and academic coaching programs, reduces financial strain and supports student success. The simulation center expands access to hands-on learning across routine and high-acuity clinical scenarios while supporting interprofessional education. Finally, a growing body of research conducted under the auspices of the NJ-MEP reframes clinical precepting as a central educational and workforce system, thereby shaping training quality, equity, and long-term workforce viability. Together, these 4 components demonstrate the positive impact of a state-funded investment in midwifery education.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Perceptions of Sexual Function During the Postpartum Period: Systematic Review of Qualitative Evidence.","authors":"Verónica Mejía-Mercado, Cristina Gallego-Gómez, Ana Torres-Costoso, Vicente Martínez-Vizcaíno, Claudia Andrea Quezada-Bascuñán, Sandra Martínez-Bustelo, Eva Rodríguez-Gutiérrez, Sergio Núnez de Arenas-Arroyo, Asunción Ferri-Morales","doi":"10.1111/jmwh.70178","DOIUrl":"https://doi.org/10.1111/jmwh.70178","url":null,"abstract":"<p><strong>Introduction: </strong>Sexuality is a multifaceted aspect of life influenced by several dimensions, including biology, psychology, socioeconomics, and spirituality. Postpartum sexual health remains an understudied and relevant area for women. This systematic review of qualitative studies aimed to synthesize knowledge of the perceptions of sexuality of women who are postpartum in relation to their psychosexual adjustment and sexual functioning and the contextual and relational influences affecting them during this period.</p><p><strong>Methods: </strong>From database inception until January 31, 2026, a comprehensive search of qualitative findings was conducted across the MEDLINE, Web of Science, SCOPUS, and PsycINFO databases. Studies reporting a qualitative analysis of the perceptions associated with sexual function in women who are postpartum were included. Study quality was assessed using a Critical Appraisal Skills Programme checklist, and findings were synthesized thematically through inductive analysis. Confidence in the results was evaluated with the GRADE-CERQual approach.</p><p><strong>Results: </strong>Fifteen qualitative studies involving women from diverse cultural settings across Europe, the Middle East, Latin America, North America, and Oceania were included, and 3 analytical themes emerged: psychosexual adjustment, sexual functioning, and contextual and relational factors. Confidence in all findings was rated high.</p><p><strong>Discussion: </strong>This meta-synthesis demonstrates that women who are postpartum often experience pain, fear, diminished sexual desire, body image concerns, and cultural constraints, frequently within a context of insufficient support and systemic silence. It is essential to recognize sexuality as an integral part of postpartum health to promote comprehensive, evidence-based, woman-focused care.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pregnant Women's Risk Perception and Uptake of Antenatal Care Practices.","authors":"Zozan Duran Aysel, Fatma Koruk, Ibrahim Koruk","doi":"10.1111/jmwh.70170","DOIUrl":"https://doi.org/10.1111/jmwh.70170","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant women's perceptions of pregnancy-related risk may influence their engagement with antenatal care practices, yet this relationship has not been sufficiently examined in routine primary care settings. Understanding this association is important for improving the provision of antenatal care. This study aimed to determine pregnant women's uptake of antenatal care practices and to examine the relationship between pregnancy-related risk perception and the uptake of care.</p><p><strong>Methods: </strong>This cross-sectional study included 270 pregnant women in their third trimester receiving primary health care services in a southeastern region of Türkiye. Participants were recruited via cluster sampling. Data were collected through face-to-face interviews using a data collection form and the Pregnancy Risk Perception Scale. Descriptive statistics, univariate analyses, and multivariable logistic regression were used to examine associations.</p><p><strong>Results: </strong>Regular antenatal follow-up was reported by 97.4% of participants. Uptake varied across practices: 49.6% underwent oral glucose tolerance testing, 84.4% used iron supplements, 84.1% used vitamin D supplements, and 82.6% received tetanus vaccination. The mean (SD) total risk perception score was 4.0 (1.66), indicating low to moderate perceived risk. Higher risk perception was significantly associated with greater uptake of all antenatal care practices (P < .05).</p><p><strong>Discussion: </strong>Pregnancy-related risk perception is a key determinant of women's engagement with antenatal care. Incorporating assessment of perceived risk into routine antenatal care may support informed decision-making and improve uptake of recommended screening, supplementation, and immunization practices, thereby enhancing maternal engagement and health outcomes.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Interventions During Pregnancy Improve Maternal and Neonatal Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Güleren Sabuncular, Elif Akbaş, Elif Uca, Rabia Bağlayici, Döndü Kurnaz, Şule Aktaç","doi":"10.1111/jmwh.70172","DOIUrl":"https://doi.org/10.1111/jmwh.70172","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis aimed to evaluate the effects of nutritional interventions during pregnancy on maternal and neonatal outcomes.</p><p><strong>Methods: </strong>The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO (CRD42024528918). Randomized controlled trials published between 2014 and 2024 were identified through systematic searches conducted between May and July 2024. Methodological quality was assessed using the Revised Cochrane Risk of Bias tool, version 2, and the certainty of evidence was rated with Grading of Recommendations Assessment, Development and Evaluation. Pooled estimates were calculated using a random-effects model.</p><p><strong>Results: </strong>Twenty-three trials involving 9389 participants were included. Nutritional interventions significantly increased birth weight within healthy limits and reduced the risks of low birth weight, small for gestational age, preterm birth, and gestational diabetes mellitus. No significant effects were observed for macrosomia, large for gestational age, birth length, head circumference, gestational hypertension, preeclampsia, maternal anemia, cesarean birth, or neonatal intensive care unit admission. Subgroup analyses showed stronger effects for personalized counseling, interventions with 4 or more sessions, and programs including food supply.</p><p><strong>Discussion: </strong>Nutritional interventions during pregnancy are crucial for reducing major adverse outcomes such as gestational diabetes mellitus and preterm birth. Integrating structured nutritional counseling into antenatal care may contribute to improved population-level maternal and child health.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Inflammatory Breast Cancer From Lactational Mastitis: A Diagnostic Challenge.","authors":"Irena Zakarija-Grković","doi":"10.1111/jmwh.70171","DOIUrl":"10.1111/jmwh.70171","url":null,"abstract":"<p><p>Inflammatory breast cancer (IBC) is a rare but aggressive form of cancer; hence, early diagnosis is essential. Although predominantly occurring in older women, it can occur during pregnancy and lactation, making the diagnosis especially challenging. IBC is characterized by erythema and edema of the breast skin, with or without an underlying palpable mass. In pregnant and postpartum women, it can be easily confused with lactational mastitis. Awareness of the history and clinical signs of IBC, and how it differs from lactational mastitis, increases the likelihood that women will receive due care and have a chance at survival. Midwives play a key role in early recognition of breast abnormalities, given the multiple opportunities during pregnancy, birth, and the postpartum period to observe women's breasts. This Clinical Rounds article presents a real case of IBC in a postpartum woman. Discussion of the clinical presentation, diagnostic tips, and appropriate management options are included and compared with the diagnosis and management of lactational mastitis.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives' Communication Practices About Risk and Racism With Black Women During Pregnancy: \"We've Got to Find a Way\".","authors":"Emily Dove-Medows, Cathrine Corwin, Alison R Walsh","doi":"10.1111/jmwh.70168","DOIUrl":"https://doi.org/10.1111/jmwh.70168","url":null,"abstract":"<p><strong>Introduction: </strong>A growing body of literature suggests that patient-provider communication in perinatal care is a key factor in addressing inequities in pregnancy outcomes. The purpose of this study was to explore how a sample of midwives who provide perinatal care perceive their communication practices about racism-related risks with Black women who are pregnant during clinical encounters.</p><p><strong>Methods: </strong>Fourteen midwives from a national mixed-methods study completed semistructured interviews about communication practices regarding pregnancy risks during prenatal care. Interviews were analyzed using thematic analysis.</p><p><strong>Results: </strong>Three themes developed. Evolving Communication describes the multitude of ways participants engaged in patient-centered communication over time, tailored to the needs of individual patients and circumstances. Tension describes the internal conflict midwives experience when they want to address racism in conversations but fear causing offense, harm, or misunderstanding. Room for Growth was defined as the lack of formal training and the desire to learn more about incorporating discussions about structural racism into communication with Black women when discussing risks or complications during pregnancy.</p><p><strong>Discussion: </strong>Midwives in this study deployed adaptive communication strategies while experiencing tension between wanting to convey accurate information effectively and being considerate of how their communication might be received. Education and training in best practices for communicating with patients who are diverse may help reduce clinicians' reticence to raise potentially charged topics and support open, frank dialogue. Midwives have a clear commitment to ensuring Black patients are seen, heard, and receive excellent care, and there is a need for midwifery education to include training on communicating about how structural racism and contextual factors drive health care.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to Treating Kratom Use Disorder in the Perinatal Population.","authors":"James Hardy, Amy Marietta, Nathan Mullins, Olivia Caron","doi":"10.1111/jmwh.70169","DOIUrl":"https://doi.org/10.1111/jmwh.70169","url":null,"abstract":"<p><p>Kratom is an emerging substance in the United States that is commonly used to manage chronic pain and withdrawal symptoms from opioids. Kratom products are federally unregulated and legal in many states, and prolonged use can lead to the development of a substance use disorder. For pregnant persons, there are additional risks of maternal and infant withdrawal symptoms. Treatment of kratom use disorder (KUD) is complicated by misperception of the substance's harmful effects as well as limited screening options to identify and track use. There are few reports on the management of perinatal KUD and outcomes following childbirth. Buprenorphine has limited evidence for the treatment of KUD in the general population. This medication is supported for the treatment of opioid use disorder in pregnancy, but only 3 cases describe its application for pregnant persons with KUD. Key considerations for this treatment approach include identifying an effective buprenorphine dose and using collaborative care to address patient concerns. This case study illustrates strategies for the diagnosis and management of KUD in pregnancy.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider Perspectives on Community Birth Transfers: Analysis of Personal Values and Attitudes Toward Community Birth Among Maternity Care Providers in Community and Hospital Settings.","authors":"Samantha Shao, Krishna Unadkat, Yan Li, Laura Geldmaker, Courtney McEwen Cho, Julie Lamppa, Rebecca Smith, Alyssa Larish","doi":"10.1111/jmwh.70167","DOIUrl":"https://doi.org/10.1111/jmwh.70167","url":null,"abstract":"<p><strong>Introduction: </strong>Out-of-hospital community births account for 1.6% to 2% of births in the United States and are associated with fewer obstetric interventions but increased neonatal risk. Little is known about how maternity care providers' characteristics, values, and prior exposure to community birth influence attitudes toward community birth.</p><p><strong>Methods: </strong>We conducted an observational cross-sectional survey using a 40 to 43 item Research Electronic Data Capture questionnaire distributed October 2 to 30, 2024. Eligible participants (\"providers\") included in-hospital physicians, midwives, community birth providers, and registered nurses. The survey assessed demographics, practice characteristics, provider values, prior community birth experience, and attitudes toward community birth. Descriptive statistics were used to summarize characteristics. Group comparisons between in-hospital and community birth providers were conducted using analysis of variance and χ² or Fisher exact tests. Associations between attitudes and provider values were evaluated using linear models with Bonferroni correction.</p><p><strong>Results: </strong>Sixty-seven providers completed the survey (51 in hospital, 16 community based). Most respondents were female (89.6%) and White (77.6%), with a median of 7 years in practice (IQR, 3-14.5). Attitudes significantly differed by role (P =  .007) and credentials (P =  .002). In-hospital providers reported safety concerns about community birth and perceived antenatal counseling to be inadequate. Perceived patient distrust during transfer was common among both in-hospital and community-based providers (69% and 81%, respectively). After adjustment for provider role and multiple comparisons, no significant differences in personal values were noted by attitude group; however, providers with positive attitudes toward community birth were more likely to believe that patients value compassion (β = 2.3, P =  .004).</p><p><strong>Discussion: </strong>Provider attitudes toward community birth appear to be shaped more by professional role and clinical experience than by differences in underlying value systems. High levels of perceived patient distrust during transfer highlight the need for interventions that strengthen compassion across maternity care settings.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Medicaid Participation for Community Midwives in California.","authors":"Jessica M Harrison, Ariana Thompson-Lastad, Chanda Williams, Sara Jhanjar, Mounika Parimi, Jennifer T Dunn, Maria T Chao, Jennifer James, Liz Donnelly, Holly Smith, Tanya Khemet Taiwo","doi":"10.1111/jmwh.70157","DOIUrl":"10.1111/jmwh.70157","url":null,"abstract":"<p><strong>Introduction: </strong>The United States faces persistent perinatal health care inequities, and there is growing recognition that midwifery care, including community-based care offered outside of hospital settings, could address these challenges. Medicaid finances half of the births in the United States, but state policies notably limit access to community midwifery care for people insured through Medicaid.</p><p><strong>Methods: </strong>To understand barriers to Medicaid participation and how community midwives navigate these barriers in practice, we conducted a qualitative, interview-based study with midwives (n = 62) and nonmidwife birth center administrators (n = 2) in independent home birth practices and freestanding birth centers in California; data were collected between 2022 and 2025.</p><p><strong>Results: </strong>The main barriers community midwives face to becoming Medicaid providers in California include: (1) extremely low reimbursement rates for the extensive continuity of care community midwives provide; (2) liability insurance and birth center licensing requirements that are unaffordable and not reflective of community birth settings; and (3) complex administrative bureaucracy that places undue burden on these independent clinicians. Midwives expressed a commitment to being accessible within their communities and striving to provide care to people across the socioeconomic spectrum. Because of the numerous barriers to being Medicaid providers, midwives employed various workarounds to increase access to midwifery care.</p><p><strong>Discussion: </strong>The expansion of midwifery care is a critical intervention to improve perinatal health care in the United States, although access to the midwifery model of care remains suppressed by a fragmented approach to insurance and long-standing marginalization of US midwives. In California, structural barriers make Medicaid participation administratively inaccessible and financially unsustainable for most community midwives. These findings have national implications for improving state Medicaid policies, such as by reducing administrative burdens, improving reimbursement rates, and restructuring the payment model; doing so could increase access to community midwifery care and improve perinatal health care outcomes.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Landmark Policy for Community Midwifery: The Coalition Effort Behind Massachusetts' 2024 Maternal Health Omnibus Law.","authors":"Katherine J Rushfirth, Rebecca S Herman, Erin K George, Amy H Goh, Susan Hernandez, Tiffany Vassell, Nashira Baril, Emily Anesta","doi":"10.1111/jmwh.70147","DOIUrl":"https://doi.org/10.1111/jmwh.70147","url":null,"abstract":"<p><p>Historically, Massachusetts has lagged behind much of the United States with limited midwifery access and curtailed options for community birth across the state. Over the past 2 decades, significant coalition building and political action culminated in the 2024 passage of the Massachusetts maternal health omnibus law. The purpose of this article is to describe the many events that unfolded to achieve this landmark legislation. This law was enacted through evidence-informed policy and was grounded in reproductive justice. It modernized birth center regulations, established a licensure pathway for certified professional midwives, and improved reimbursement for midwifery services. The passage of this law demonstrates how coalition power can redress long-standing structural barriers to midwifery services and community birth.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}